压力接种训练联合结构式心理干预在局限性肾癌患者后腹腔镜根治性肾切除术围术期的应用

Stress inoculation training combined with structured psychological intervention in the perioperative period of posterior laparoscopic radical nephrectomy in patients with localized renal cell carcinoma

目的探究压力接种训练(SIT)联合结构式心理干预在局限性肾癌(LRC)患者后腹腔镜根治性肾切除术围术期的应用效果。方法选取2018年1月至2019年12月在海军军医大学第三附属医院接受后腹腔镜根治性肾切除术治疗的LRC患者103例,采用随机数表法分为观察组和对照组,分别有患者51例和52例。其中观察组患者采用SIT联合结构式心理干预护理,对照组患者仅行结构式心理干预护理。观察对比两组患者的预后情况,采用汉密尔顿抑郁量表(HAMD)、一般自我效能感量表(GSES)、压力知觉量表中文版(CPSS)检测两组患者护理前后抑郁、自我效能、压力水平变化,采用医学应对问卷中文版(MCMQ)检测两组患者的应对方式并记录两组患者的并发症发生情况。结果观察组患者的术后首次排气时间、术后引流管放置时间、术后静脉输液时间均短于对照组(均P<0.05),两组的术中出血量无显著差异(P>0.05);护理后,观察组的HAMD、CPSS、MCMQ回避/屈服评分均低于对照组(均P<0.05),GSES评分、MCMQ面对评分均高于对照组(均P<0.05);观察组的并发症总发生率低于对照组(P<0.05)。结论SIT联合结构式心理干预能够有效改善接受后腹腔镜根治性肾切除术治疗的LRC患者围术期的心理压力和面对方式,降低其术后并发症发生率、加快患者术后修复时间,值得在临床护理中推广。

Objective To explore the application effect of stress inoculation training(SIT)combined with structural psychological intervention during retroperitoneal laparoscopic radical nephrectomy for patients with localized renal cell carcinoma(LRC).Methods A total of 103 patients with LRC who underwent retroperitoneal laparoscopic radical nephrectomy in this hospital from January 2018 to December 2019 were selected and divided into observation group(51 cases)and control group(52 cases)by random number table method.The observation group received SIT and structural psychological intervention,while the control group received structural psychological intervention alone.The prognosis of the two groups was compared.The Hamilton Depression Scale(HAMD),general self-efficacy scale(GSES),and Chinese Version Perceived Stress Scale(CPSS)were used to evaluate depression,self-efficacy,and stress levels of the two groups before and after nursing.The Medical Coping Modes Questionnaire(MCMQ)was used to assess the coping styles of the two groups,and the incidence of complications was recorded.Results The postoperative first exhaust time,postoperative drainage time,postoperative intravenous infusion time of the observation group were shorter than those of the control group(P<0.05),but there was no significant difference in intraoperative blood loss between the two groups(P>0.05).After nursing,the HAMD scores,CPSS scores,and MCMQ avoidance/yielding scores of the observation group were lower than those of the control group(P<0.05),while the GSES scores and MCMQ facing score were higher than those of the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusions SIT combined with structural psychological intervention can effectively improve the perioperative psychological pressure and coping styles of patients with LRC undergoing retroperitoneal laparoscopic radical nephrectomy while reducing the incidence of postoperative complications and accelerating postoperative recovery.